# MIKKELSEN, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124328877
- **Authorized official:** MR. LINCOLN MIKKELSEN (MANAGER)
- **Authorized official phone:** (616) 723-5020

## Contact information

- **Practice address:** 4200 SOUTH FWY, SUITE 615, FORT WORTH, TX 76115-1400
- **Practice address phone:** (817) 210-4778
- **Mailing address:** 4200 SOUTH FWY, SUITE 615, FORT WORTH, TX 76115-1400
- **Mailing address phone:** (817) 210-4778

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 10/28/2010
- **Last updated:** 10/28/2010